Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA DOMANGUE BOURG, PHD
ActiveAMANDA DOMANGUE BOURG, PHD is a Counseling Psychologist healthcare provider located in TELLICO PLAINS, Tennessee. NPI 1386758068 is currently active in the NPPES registry. Verify at CMS.
Counseling Psychologist · TELLICO PLAINS, TN
Registration Details
- NPI Number
- 1386758068
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 18, 2006 (20.011947574964 yrs)
- Last Updated
- Oct 13, 2022
- Licenses
-
3783 (TN)915 (LA)
Practice Information
- Address
-
171 BANK ST # 221TELLICO PLAINS, TN, 373854987Browse TN providers · Browse ZIP 37385
- Phone
- 4433790447
- Primary Specialty
-
Counseling Psychologist
103TC1900X
- Additional Specialty
- Counseling Psychologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.